Individual provider · Type 1 NPI

Edwardo J. Medina Jr., PHD THD

Mental Health Counselor · Staten Island, NY

NPI number 1437370137 Active

Practice location

800 Manor Rd #2V, Professional Suites #2V
Staten Island, NY 10314-7016

Call (646) 266-4010 Map

Fax (718) 761-5562

Mailing address

PO Box 0891, Kabbelah SW Ny Nj Group
Staten Island, NY 10314-0891

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XSW081981
Clinical Social Worker 1041C0700XSW081981
Marriage & Family Therapist 106H00000XSW081981

Mental Health Counselor: Definition to come...

Other mental health counselor providers in Staten Island

See all in Staten Island →

About NPI 1437370137

Edwardo J. Medina Jr., PHD THD's National Provider Identifier is 1437370137, issued on May 1, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Staten Island, NY. The record was last updated on Sep 11, 2025.